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Monday, August 30, 2010

MiM Mailbag: Give up the dream?

I just love your blog, from the touching to the funny, all of it real.

I have a question I'd love posed to your readers (feel free to edit it down if I'm so lucky as to have it used, I tend to get wordy):

I have wanted to be a doctor since I was a young teenager. I entered undergrad taking courses that would prepare me for the MCAT and med school, I met with advisers. Then I either got scared or realized I was too immature (the answer depends on how you look at it) and switched to a major in the liberal arts school. Graduated, then looked into taking the MCAT again, but then my boyfriend (now husband) and I moved, married and had kids and I put my dream on indefinite hold.

Every six months or so I spend time looking up medical school prerequisites and local post-bacc programs and read message boards and blogs of moms who have done medical school with children. Crazily enough, I am not entirely daunted by the tales of long hours, pressure and scant family time.

However, I am in my early 30s and I have four kids. Four kids under the age of 8.

Every bit of sense I have tells me, "Don't even dream it, give up before you start, you can't possibly make it work and keep your family intact." And yet I keep reading stories of people who've done just that.

So I want to ask some questions of those who went to medical school after they had kids. Do your kids resent the time your training takes? How did they take it if you had to move? Would you do it again at the same stage in life? Will you have enough time to pay off your student loans if you don't start practicing until you're 40 (or older!)? Is it worth it??

I am so torn. I really, really want to do this and think I could do it, but I worry about the kids.

Thank you!

Signed,

Anonymous, so my friends don't think I'm crazy before I've even jumped into the crazy pool

20 comments:

I don't have kids, but most of the attendings I know say it's easier to have kids BEFORE med school than AFTER.

The main reason I'm commenting is that, while I'm doing a slightly different path than you are, I'm not going to be an attending either until I'm in my 40s (I'm 33 now and in the middle of my program). This is because I'm doing MD-PhD, and will also have to do fellowship in order to secure an tenure track position. My husband and I will probably have kid(s) during my PhD. I'm fortunate because he has a good job and both out families are very supportive of me. I can't imagine doing anything else, and so far have no regrets. It's never really occurred to me that any kid I had would "resent" my career, but that's probably because my mom had a career herself, and I know I'm not cut out for stay-at-home mom-hood.

I started med school with 4 kids ages 7 and under. They do not resent me -they are soo excited for me. Their teachers tell me all the time how proud they are. However, I never made medical school 'my' thing. i made it our thing. Before embarking on it, I had long talks with my husband and kids and I would not have done it without their full support. I think that made a huge difference. I phrase things in the plural like 'when we are in residency' because honestly, when we move for residency, they will be sacrificing too so they are 100% part of this. We are all a part of mommy being a doctor and we are all contributing to it, so we all 'own it'. Does that make sense? I have also always been honest about the down sides. I have missed school parties and stuff (my husband always goes if I can not make it) but they know ahead of time that I won't be there but that I love them, and that we are getting closer to our goal as a family etc etc.

So, to answer your question - you can totally do it! Get your family support and it will make the transition much easier. :)

There was a resident at my program who had three kids when she started med school and she made it work without psychologically damaging the kids :)

That said, my mom went to med school when I was very young and though I don't resent her for it, I remember feeling really sad and missing her a lot during the residency years. I'm not saying that's a reason to give up on your dream, but do you think there's any chance you might be happy doing something that is similar to being a doctor but doesn't require the same rigorous training, like being a PA? The PAs I've met all do similar things to MDs and make a good salary.

One of my friends went through veterinary school with four kids under the age of ten and a completely unsupportive (useless) ex-husband. As IndyMom said, they worked together as a family. My friend said having kids made her more efficient in her work habits; every day, at the end of the day, she was Mom and done studying.

I think it's all about how your family functions and how you communicate with your husband and children. I don't have any kids now, but I'm 27 and applying to med school this year. My OB told me this year that if we wanted more than 2, we should start now. He actually told me that in terms of emotional and physical stress, having a non-newborn child before my 1st year would be better than having a child during 1st year. My OB is an attending and teaches med students and residents, so I felt like his advice was worth the 2 cents. OldMdGirl said that another attending told her that it's best not to have children until later. You see, no one can really offer you "the" solution, but rather experiences of their own. A friend of mine has 3 kids, is 32 and is applying with me. She did her post bacc and MCAT with all 3 (1 newborn) and they made it. She worked part time, too. She did it with spousal support and her parents' help. If you have those, I think that makes a world of difference. Her husband is super supportive, but she is also very smart and can study after the kids are in bed and still make her 3.9.

It is stressful and full of sacrifices, but in the end, it's SO worth it, I think. I saw my parents go through residencies as a teenager and although I do have some moments of lost time, their happiness and our family's unity now after all of it, are so much better! I hope your family figures it out and can fit your dreams into the picture!

I'm doing post-bacc premedical requirements now (and working), and so far, it's been okay on the family. Stressful at times, but mostly good!

I think when it finally came down to making a decision as to whether to pursue the doctor dream (or not), I realized that I would always be full of regret if I didn't at least try and fail (or try and end up changing my mind).

I work at a hospital (as an aide), but one thing that I've learned is that there are a few hospitals in my area that will actually pay 100% to put you through NP or PA school. So, if finances and student debt are a big limiting factor for you, that might be another idea worth considering.

Hi, Anonymous. I am doing medical school as a single mom with two kids, and one of my favorite 4th years last year was in her late thirties with 5 kids. She matched at her first choice and is now doing a residency in emergency medicine, and her husband is a PGY 2 at the same facility, I think in PM&R.

It is doable. It will take dedication and juggling, but so does motherhood in general.

One of my favorite peds path attendings had three kids when she started medical school and she graduated AOA at the top of her class and is part of an exclusive pediatric research team on vascular malformations - was always flying around the world for conferences. When I signed out cases with her, she took phone calls from her daughter in college offering support. One of my funniest sign outs ever was watching her juggle her junior high son's phone call - he had repeatedly flushed a toilet and it was overflowing through the ceiling onto an heirloom dining room table from her husband's side of the family. She was simultaneously giving him instructions to cut off water on toilet and get towels on the table, answering her lab assistant's research questions, and apologizing to me for all the interruptions. She was unflappable.

I echo above - you can do it! Having kids in residency was pretty trying. There is no wrong or right. Planning and family support is key.

Old "Rock Star" MD Girl - you are only 33!!?? I just turned 37. That must make me Ancient MD Girl.

Thank you all so much for responding! I especially liked hearing from those of you who had physician parents, it's been hard to find opinions from that perspective.

My husband is not on board right now, he thinks it would be asking a lot of him and the kids. I think that may be his way of saying, "No way!" in a more gentle manner.

A good friend of mine told me, "You made your choice to have kids, I feel like your time to pursue medicine has passed." So I'm feeling a little defeated right now, and don't want to tell anyone else about it unless I know I'm going for it, which at this point, without my husband's support of the idea, doesn't seem likely.

Don't feel defeated by the negative ?friend. Why not wade into things slowly. Take a single pre-med requisite course at night. Something that would help prepare for the MCAT's. If it's overwhelming or you don't like it, nothing much lost. If you feel it's leading to something you really want, continue to accumulate a few courses until you're ready to really plunge in.

If you haven't looked into PA schools, I would highly recommend it! After finishing your pre-req's, the training is two years (full time, including summers). If you go the NP route, you'd have to become an RN first, then 2 yrs of NP school, and you have to choose a tract (peds, women's health, etc which limits where you can practice). PAs have a lot of versatility in practicing in any specialty, primary care or surgical field out there, and you can change fields readily because the training is broad. Work hours are good (but can be as demanding as MD hours, depending on what field you go into). Salaries are good, and there is an awful lot of independence (with the benefit of having MD backup). A great way to feel this career out is to shadow PAs in various fields to get an idea of their scope of practice, their training, and abilities. PAs are trained in the medical model and at our university share some classes with med students. One caveat to PA admissions is that most schools require at least 6 months of patient care experience.

i am sure you can do whatever you want to do and your kids will be fine. that said, depending on why i wanted to be a doctor, I'd think about being a PA. I couldn't do what I do (academic research career) as a PA, but if what I wanted was to see and help patients and work with collaboratively with other people (with a diverse choice of practice settings available (emergency departments, chronic rehab hospitals, outpatient settings, surgery, etc.), I'd be a PA in your shoes.

Tigermom, I am a big fan of this philosophy as well, but it doesn't matter much whether momma is happy or NOT if Daddy has decided not to support Momma and two kids have chicken pox on a bad clinical day.

The OP has said her husband does not support her desire to go to med school. One can't unilaterally change the marital plan without understanding that one "NO" is a veto, just like married people should not buy houses or have babies unless both partners are on board.

I agree with the OP's friend--she made her choice, four times over. If her spouse and family are not 100% ready to support this venture, then she will have to wait the next 16, 17, or 18 years until she is again free to do as she pleases.

I am all for chasing dreams but I think it will be hard if not impossible for you to take this path if your family does not support you 110%.

For now you might look into starting slow w/ a course or two (as suggested above) and/or looking into some other programs (such as PA) which may give you what you are looking for in terms of patient care without as much of a sacrifice of time in training. Maybe your husband will come around or maybe over time you'll be able to convince him that you really, really need to do this.

Medicine is a wonderful career, but at the end of the day it's just one more way to earn a living and it is NOT worth splitting your family up just to get an MD behind your name.

My clinical mentor told me this, and I believe it is true: "You can have anything you want but you can't have everything."

OP here - Thank you again for more responses, I really appreciate it. What I do sometimes find sad is that if I were the daddy instead of the mommy, there would be much less to debate. If my husband decided to go to medical school, people wouldn't be telling him, "You have kids, you can't do that!" Well, perhaps they would, but it would be said less often.

For those who agree I've already made my choice by having children, do you think women need to choose between children and medicine all the time, or just women who already have children before beginning the journey? At what point is it acceptable for a female MD to have kids? I'm truly curious! A friend of mine is a doctor and she waited until she was totally done with her training to have children, then had to deal with colleagues upset she was taking maternity leave shortly after joining a practice. And she worked her daughter's entire first four years of life, whereas someone starting after having kids could wait until those children were in school and out of the house most of the day, anyway. Is one way better than the other?

Unfortunately, I don't have time on my side, so if pursuing medicine would be a little crazy now, it would be even more so when I'm 50 and would only have maybe 10 years of practicing when I'm done training.

I will look more into going the PA route, that is an interesting option. I know that if I have to talk my husband into med school, things would not work for either of us, he'd resent being pressured into it and I'd resent his lack of support, so medical school is probably not in the cards for me. I think he would be far more accepting of it if I could guarantee we wouldn't have to move, but that isn't likely at all! It's not so much the time and money issues for him as it is uprooting our family a possible 2-3 times, at least. And I hear very little from mom MDs how moving affected their kids!

I went to medical school in my early 40s with a preschooler and 2 grade-school kids. The ONLY way it worked was that my husband basically did everything for 8 years (residency in obgyn, before hours limits). We moved cross-country for residency and the by then 15-year-old hated me for a while but after making new friends she was fine as were the younger two. Moving was not a problem. But doing it all would have been impossible without my husband's total support for my dream.

I'm 27, I'm married, and I have two kids (ages 8 and 5) and the youngest has special medical needs. A little over a year ago, I decided to take the plunge because I just can't imagine myself being fulfilled in another career path.

Last year, I started taking my premed courses during the evenings, slowly, and this year I'm going to school full time during the day, as well as volunteering and shadowing. It is busy and most of the time I'm pretty sure I'm nuts to be doing it, but at the same time I love it. My husband is 100% supportive and I have excellent family support nearby...or else there is no way I could be doing it. My kids are actually very excited that I am back in school pursuing this!

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